Consequences of Anabolic-Androgenic Steroid Abuse in Males: Sexual and Reproductive Perspective

June 2021 in “ The world journal of men's health ”

Giovanni Corona, Giulia Rastrelli, Sara Marchiani, Sandra Filippi, Annamaria Morelli, Erica Sarchielli, Alessandra Sforza, Linda Vignozzi, Mario Maggi

anabolic-androgenic steroids AAS testosterone luteinizing hormone LH follicle-stimulating hormone FSH estradiol hypothalamus-pituitary-testis axis HPT axis hCG SERMs acne hair loss gynecomastia steroids human chorionic gonadotropin selective estrogen receptor modulators man boobs

TLDR Using anabolic-androgenic steroids can harm men's reproductive health and increase the risk of heart problems and death.

Chronic anabolic-androgenic steroid (AAS) abuse in males significantly disrupts reproductive and sexual health, leading to reduced endogenous testosterone, impaired sperm production, and side effects like acne, hair loss, and gynecomastia. A meta-analysis of 24 studies with 2,411 patients showed lower luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels, but higher testosterone and estradiol levels in AAS users. AAS abuse also worsens metabolic profiles, increasing cardiovascular risks and causing sexual dysfunctions such as erectile dysfunction and reduced libido. Recovery of the hypothalamus-pituitary-testis (HPT) axis post-AAS withdrawal varies, with sperm recovery taking up to 24 months. Management lacks clear guidelines, but therapies like hCG and SERMs are suggested for faster recovery.

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